Individual
DEANNA L KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4100 LAKE OTIS PKWY STE 222, ANCHORAGE, AK 99508-5230
(907) 550-6100
Mailing address
4100 LAKE OTIS PKWY STE 222, ANCHORAGE, AK 99508-5230
(907) 550-6100
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
342
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
342
PROFESSIONAL LISCENSE
AK
05
—
AN1290
—
SC
Enumeration date
06/16/2006
Last updated
10/18/2011
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